Intubating or naso-gastric devices in one form or another have been known for centuries and are used to provide nourishment to human patients, many of whom may be comatose or semi-comatose, who are otherwise unable to take nourishment. For example, following surgery a patient may need such a device for a brief period of time during recovery. Typically, such devices consist of four parts or elements, namely, a flexible feeding tube for conveying nourishment, a stylet preferably made of metal for positioning the feeding tube, a Bolus tube or weight for positioning the feeding tube in the duodena or jejunal and a connector for attachment of a supply of nourishment to the feeding tube.
In the use of intubating or naso-gastric devices it is, of course, essential that the device be properly positioned in order that it can accomplish its desired function. It is also important that the device be properly positioned as quickly and expeditiously as possible. Due to the fact that the device extends into the patient, it is not possible to visually observe the positioning of the device. For this reason, it has become necessary to develop ways and means of determining the position of the intubating device within the patient.
One way of determining the position of the intubating device is to make the feeding tube of a radio-opaque material so that its position can be determined by X-ray or the like. This procedure is time consuming and subjects the patient to additional X-rays.
Another procedure for determining the position of the intubating device is to feed air through the feeding tube. The physician can then listen for the bubbling air with a stethoscope or the like and determine the position of the tube.
Another procedure for determining the position of the intubating device is to aspirate the stomach through the feeding tube and determine the contents by removing the contents with a syringe or the like.
The problem with the above procedures for determining the position of the intubating device is that most of these procedures require removal of the metal stylet before they can be carried out. If it is determined that the intubating device is improperly positioned then the stylet must be reinserted in the feeding tube. The reinsertion of the stylet may result in considerable discomfort and possible danger to the patient.
There are numerous prior art patents relating to intubating or naso-gastric devices including: Hargest U.S. Pat. No. 4,249,535; Stevens U.S. Pat. No. 3,503,385; Pezak U.S. Pat. No. 3,395,711; Guss U.S. Pat. No. 4,033,331: Fettel U.S. Pat. No. 3,896,815; Linder U.S. Pat. No. 3,957,055; Ring U.S. Pat. No. 3,964,488; Wallace U.S. Pat. No. 2,688,329; Dick U.S. Pat. No. 3,070,089.
Another United States patent of interest is the Waters U.S. Pat. No. 4,388,076, granted June 14, 1983. This patent purports to be directed to the problem of repositioning the intubating device in the event it is found to have been incorrectly positioned in the first instance.
This patent discloses a flexible feeding tube having discharge openings at one end. There is a metal stylet positioned in telescoping relationship within the feeding tube. The proximal end of the flexible feeding tube is attached to a connector which, in turn, is adapted to be connected to a syringe so that the syringe communicates with the interior of the flexible feeding tube. The metal stylet extends through the flexible tube and into the bore of the connector.
The terminal end of the metal stylet is formed into a hook which is positioned and secured within the passageway of the connector. The stylet is removed before the process of feeding liquid nourishment to the patient.
The positioning of the hook member is a task requiring a certain amount of manipulative skill and, with the stylet in this position, there is the possibility of clogging the passageway.